Doctor Name: | AMY JO KISTNER |
NPI Number: | 1700953114 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, LPC |
License Number: | |
Business Practice Address: | 2499 S Delaware Ave Milwaukee, WI - 532071941 |
Business Phone Number: | 4142322489 |
Business Fax Number: | |
Mailing Address: | 2499 S Delaware Ave, MILWAUKEE |
State: | WI |
Postal Code: | 532071941 |
Phone Number: | 4142322489 |
Fax Number: | |
NPI Enumeration Date: | 11/29/2006 |
NPI Last Update Date: | 04/23/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |